Earlier this month, the New York Times (NYT) reported on individuals in a minimally conscious state (MCS). Although the article headed: ‘PET Scans offer clues on Vegetative States’, its contents addressed the technologies around MCS: a ‘newly’ diagnosed state of consciousness. The paper commented that PET scans would be more beneficial than functional Magnetic Resonance Imaging (functional M.R.I.) in diagnosing this state. Around the same time, the NYT published a paper that headed: ‘Cost of treatment may influence doctors’. This paper quoted a doc saying: “There should be forces in society who should be concerned about the budget, about how many M.R.I.s we do, but they shouldn’t be functioning simultaneously as doctors,”

In this blog post I want to focus on the cost and price of consciousness. I do not only want to focus on the economic costs, but also on costs in a more holistic sense, including the psychological and emotional costs. In the end, I want to ask you: how much is consciousness worth to you?

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.bvg

You are mid 50ties, you have several university degrees from top universities, you have a PhD in Chemistry and are happily married. You seem to have a great life, but for one thing: while your legs are fully functioning, you do not want them. And it is not even that you just do not want them; you feel that they do not belong to you. They give you great suffering.

Earlier this week, the Huffington Post reports on Cloe Jennings who suffers from her healthy legs. Reportedly, she suffered from her legs since she was 4 years old and has held the desire to have them amputated or to be paralysed from that time. Jennings is raising money to travel to a surgeon who has offered to help her.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

Medical situations can instantly change. This can be for the better or for the worse: A patient who consistently refused to eat, now suddenly decides to eat. A patient who is delirious or manic threatens a staff member at 11:50, but subsequently seems rational and reasonable when we arrive in his room 15 minutes later. A stroke patient who does not communicate or respond, and who is likely to develop into a permanent vegetative state (PVS), perks up, talks and leaves. A patient, who is on the mend, develops a fever, requires a rapid response and dies.

The ethical issues, similarly, change instantly in these situations. It requires me, as a new clinical ethics, to constantly redefine my perspectives. Where we plan to discuss placement of a feeding tube, the patient’s mood alteration resolves issues around placement and resolves the ethical questions. Where we address concerns around a safe discharge, we find out that the patient’s mood changes at 12 o' clock, and awareness of this time frame allows for a safe discharge. Where have family meetings to discuss quality of life in a PVS, this discussion is no longer necessary as the patient can be discharged.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

As a new clinical ethicist in training, I’m allowed to take some looks in the metaphorical kitchen of the hospital where things really happen: seeing research and treatment in practice. This is an amazing experience, as I always thought of myself in the court room (my primary degree is in law) and I had never pictured myself in an operating room. Thanks to all the compassionate and generous physicians in this hospital, who allow me to peek in their kitchen (as long as I don’t function as the ethics police), I get an understanding of the difference between the ivory tower of academic (bio) medical ethics and the real ethical issues of the work floor.

Not too long ago I observed a WADA test in the epilepsy department. The WADA test is used to establish where language and memory are located in the brain; in which hemisphere do these capacities ‘reside’. (When we think simplistically and typically, a right-handed individual has memory and language on the left side of the brain, but there are a lot of exceptions and mixed brains). During the WADA test, doctors try to mimic a stroke of the brain; while the patient is awake, one hemisphere is temporarily sedated (around 2 minutes) and a series of tests are done to see how the patient memorizes and describes objects, based on the functioning of only 1 side of the brain. Subsequently, the other hemisphere is sedated and a similar test is performed. These tests are done, for example, to assess what would happen if a particular part of the brain is surgically removed; i.e. the area that contains the origin of the epileptic episodes.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

Dr. Adina Roskies is Associate Professor in the Department of Philosophy at Dartmouth College. Her areas of specialization are Philosophy of Science, Philosophy of Cognitive Science, and Philosophy of Mind.